Prophylactic Acyclovir Prevents Herpes Zoster Outbreaks During Bortezomib Treatment

By Martha Kerr

NEW YORK JAN 22, 2009 (Reuters Health) - Patients with multiple myeloma who are receiving bortezomib therapy benefit from prophylactic acyclovir, which effectively and completely prevents reactivation of the varicella (herpes) zoster virus, according the researchers at Northwestern University in Chicago.

Dr. Seema Singhal and colleagues conducted a review of the records of 125 multiple myeloma patients treated with bortezomib. More than 80% received routine prophylactic acyclovir 400 mg daily. The remainder received acyclovir 200 mg daily, valacyclovir 250/500 mg daily or famciclovir 500 mg daily. Patients were also educated about the importance of compliance with the antiviral treatment regimen.

Bortezomib therapy was given for 1 to 164 weeks (median = 16 weeks). The total duration of exposure to bortezomib was 4150 weeks, or 80 patient-years. The self-reported compliance with antiviral prophylaxis was near 100%.

"Not a single episode of herpes zoster was reported during this period," Dr. Singhal and colleagues report in the January 1 issue of Cancer. "No adverse effects were noted that could be definitely attributed to acyclovir, valacyclovir, or famciclovir."

Dr. Singhal told Reuters Health that acyclovir is begun at the same time as bortezomib in all patients and continued throughout chemotherapy and that there are no safety concerns or contraindications with prophylactic acyclovir.

SOURCE:

• Cancer 2009;115:229-232.



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